A phase II randomised controlled trial evaluating the feasibility and preliminary efficacy of an education program on speech-language pathologist’ self-efficacy, and self-rated competency for counselling to support psychological wellbeing in people with post-stroke aphasia

ABSTRACT

Background

Speech-language pathologists (SLPs) utilize counseling to support the psychological wellbeing of people with post-stroke aphasia, however, SLPs receive variable, usually limited, counseling education. Counseling education may be effective in improving SLPs’ knowledge, skills, and confidence in counseling in post-stroke aphasia.

Objectives

We aimed to evaluate the feasibility and preliminary efficacy of a novel online counseling education program for SLPs working with people with post-stroke aphasia.

Method

Our study was a Phase II, two-arm pilot randomized controlled trial with a waitlist control. Participants (n = 49) were stratified by previous counseling training (≥1 day) and co-work with psychologists when addressing psychological wellbeing in post-stroke aphasia, and randomized to either the education program or waitlist control arm. We developed an education program (7-hours self-directed learning; 3-hour online workshop) for the trial. Feasibility outcomes included SLP recruitment, workshop attendance, and participant attrition at follow-up. Participants’ counseling self-efficacy and self-rated competency were assessed pre- and post-program (primary endpoint) and at 5-week follow-up.

Results

Forty-four (90%) participants attended the workshop with forty-one (84%) participants completing the trial. There was a significant interaction (large effect size) between time and group supporting a positive effect of the program on counseling self-efficacy, F(1,44) = 39.402, p < . 0005, η_p² = . 472 and self-rated competency for counseling, F(1,44) = 31.824, p < . 0005, η_p² = . 420. The effects were maintained at follow-up with self-rated competency scores demonstrating further significant improvement.

Conclusions

The demonstrated feasibility and preliminary efficacy of this online counseling program warrant a future definitive trial.

KEYWORDS:

• Psychological wellbeing
• counseling
• stroke
• aphasia
• speech-language pathology

Acknowledgments

Our sincere thanks to the participants of this study.

Contributors

All authors contributed to the design, analysis, and write up of this research.

Disclosure statement

This research is part of the first author’s doctoral project. No potential conflict of interest was reported by the authors.

Ethics approval

Ethics approval was provided on 20 December 2020 by the Human Research Ethics Committees of La Trobe University (HEC20293) and University of Technology Sydney (UTS ETH 20.5453).

Additional information

Funding

The first author was supported by a La Trobe University Graduate Research Scholarship and the Research Training Program, La Trobe University. IK and MR were supported by a NHMRC Centre of Research Excellence grant #1153236